asked the Minister for Health if she expects that the increased health charges which the Coalition are introducing will result in a decline in (a) the number of subscribers and (b) the annual income of the Voluntary Health Insurance Board.
Ceisteanna — Questions. Oral Answers. - Health Service Financing.
6.
The schemes of the Voluntary Health Insurance Board are basically there to meet the needs of those who wish to opt for private care and this consideration is not affected by a change in the rate of health contributions. In the past, the introduction of the system of health contributions, and modifications made in that system did not affect the development of the Voluntary Health Insurance Board, and I do not expect that the further changes now proposed in the scheme of health contributions will result in a decline in the number of subscribers or in the income of the board.
Will the Minister not agree that the Voluntary Health Insurance Board are one of our most successful semi-State bodies and that up to this point their membership and income have been increasing? Further, will the Minister not agree that the amount of disposable income available for health insurance will be reduced for individuals because of the very large health charges being made? For example, there will be a charge of £250 per annum for a person with an income of £10,000. Will the Minister not agree that this curtailment of disposable income could have a serious effect on the membership and income of the VHI? Will he give any encouragement or assistance to the VHI Board in the preparation of measures that will offset the decline that could result from the measures taken at the current time?
I do not envisage any decline in the membership of the VHI. More than anyone else in the House the Deputy is aware that even with the increased contributions in the past few years there was an increase in the number of subscribers to the VHI. I do not see any reason why that trend should be reversed.
7.
asked the Minister for Health if she expects that the increased health charges which the Coalition are introducing will result in greater State control of the health services.
I have no expectation that the raising of additional income by way of health contributions to supplement the cost to the Exchequer of the health services will result in greater State control within the services.
Will the Minister not agree that in Ireland we have a unique and valuable mix of State and voluntary health services which has worked very well? Further, will he not agree that to take a tax of £87 million in respect of health contributions will make it more difficult for voluntary and private hospitals to survive and will force more patients to use the State-owned services? In effect, this would be nationalisation by stealth. Further, will the Minister not agree that the increased VAT, the increases in the consumer price index and the proposed increases in hospital and prescription charges announced yesterday by the Minister for Finance will accelerate this trend?
The question asked if the Minister expected that the increased health charges will result in greater State control of the health services. Now the Deputy has asked many more questions. I cannot accept that the increase in charges will result in any greater State control. As I explained to the Deputy recently, in reply to questions and in an Adjournment Debate, the figure he has quoted is out of context. It is part of a taxation package and he has not taken into account the benefits that will accrue from it.
8.
asked the Minister for Health when the increased health charges will be introduced for (a) PAYE workers, (b) farmers and (c) the self-employed.
The proposed increase in the rate of health contributions falls to be considered in association with the Government's proposals for the reform of the income tax system. As the Minister for Finance announced yesterday, these changes will have effect from the beginning of the next income tax year.
When will these changes apply to PAYE workers? I suppose they will apply from the beginning of the next income tax year. When will this proposal apply to farmers and self-employed?
I have given the information relating to PAYE workers, farmers and self-employed people. These charges will have effect from the beginning of the next income tax year.
The Minister told the House the other day that the multiplier will not be increased in the present year. Does that mean that the farmer multiplier will be increased from the beginning of the next tax year to bring in the appropriate amount of tax which has been estimated for?
That is a separate question. It does not relate to my Department.
Would the Minister not consider introducing a fully comprehensive welfare State system along the lines of the British system in order to curb some of the injustices and anomalies of our present system?
I cannot give that information to the Deputy. It is a separate matter.
Does the Minister agree that he will be doing this in another way through the measures being taken currently?
The Minister stated that the revised health contributions will be considered in the context of income tax reform. Is this not simply a new form of tax without any tax-free allowances, unlike the income tax code? Is it the intention that this so-called health contribution is to cover some proportion of the cost of the health services?
This is to maintain the existing health services. With the rapid increase in costs, the Deputy will be aware the cost of the health services is increasing every year, and the great problem is that the services have run down since last year and this is an effort to maintain the services and to improve them.
If it is a charge to maintain the health services, why does it need to be considered in the context of income tax reform?
Is the figure of £87 million not an enormous one and would any portion of that not do a great deal of good for the many requirements within the health services? Since it is not intended to apply any of this money in that direction, does the Minister not agree that Deputy O'Donoghue's analysis is the cor-correct one?
I have told the Deputy that the figure is part of an overall figure, part of a package which the Deputy seems to find great comfort in quoting. As I have told him, he is taking the figure completely out of context.